Buyuktaskin Dicle, Lewis Charles P, Nakonezny Paul A, Delaney Karina, Sangster-Carrasco Lucero, Romanowicz Magdalena, Shekunov Julia, Zaccariello Michael J, Vande Voort Jennifer L, Croarkin Paul E
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Psychiatry & Behavioral Sciences, University of Minnesota Medical School, 2001 6th Street SE, Minneapolis, MN 55454, USA.
J Affect Disord. 2025 Aug 15;383:101-107. doi: 10.1016/j.jad.2025.04.112. Epub 2025 Apr 23.
Previous research has explored Transcranial Magnetic Stimulation (TMS) interventions for suicidal thoughts and behaviors. However, the optimal dose parameters for TMS interventions targeting suicidal ideation in adolescents remain unknown. This exploratory study examined the impact of 1 Hz and 10 Hz TMS treatment on suicidal ideation in adolescents with major depressive disorder. Participants (N = 41) aged 12-18 years were randomized to TMS treatments with 1 Hz or 10 Hz frequency over 6 weeks and included in the exploratory analyses. The change in the intensity of suicidal ideation throughout treatment was estimated with ordinal logistic regression models with and without adjustments for the change in depressive symptom severity. The predicted odds of intensity of suicidal ideation significantly decreased over six-weeks of acute TMS treatment for both the 10 Hz TMS group (OR = 0.754, 95 % CI = 0.634 to 0.897, p = 0.0015) and the 1 Hz TMS group (OR = 0.780, 95 % CI = 0.668 to 0.909, p = 0.0016). However, after adjustment for the change in depression severity as a time-varying covariate in the ordinal logistic regression model, the magnitude of the decrease (or predicted odds) in intensity of suicidal ideation was attenuated and rendered non-significant for both the 10 Hz and 1 Hz TMS groups. TMS treatment suicidal ideation outcomes were not significantly different between the 10 Hz and 1 Hz TMS groups. Low-frequency TMS may be as effective as high-frequency TMS in treating suicidal ideation in adolescents with depression. Notably, 1 Hz TMS may have a favorable tolerability and safety profile for adolescents.
先前的研究已经探索了经颅磁刺激（TMS）对自杀念头和行为的干预作用。然而，针对青少年自杀意念的TMS干预的最佳剂量参数仍然未知。这项探索性研究考察了1赫兹和10赫兹TMS治疗对患有重度抑郁症的青少年自杀意念的影响。年龄在12至18岁的参与者（N = 41）被随机分配接受为期6周的1赫兹或10赫兹频率的TMS治疗，并纳入探索性分析。使用有序逻辑回归模型估计整个治疗过程中自杀意念强度的变化，该模型对抑郁症状严重程度的变化进行了调整和未调整。在急性TMS治疗的六周内，10赫兹TMS组（OR = 0.754，95%CI = 0.634至0.897，p = 0.0015）和1赫兹TMS组（OR = 0.780，95%CI = 0.668至0.909，p = 0.0016）自杀意念强度的预测几率均显著降低。然而，在有序逻辑回归模型中，将抑郁严重程度的变化作为随时间变化的协变量进行调整后，10赫兹和1赫兹TMS组自杀意念强度降低的幅度（或预测几率）均减弱且无统计学意义。10赫兹和1赫兹TMS组之间的TMS治疗自杀意念结果无显著差异。低频TMS在治疗患有抑郁症的青少年自杀意念方面可能与高频TMS一样有效。值得注意的是，1赫兹TMS对青少年可能具有良好的耐受性和安全性。
